If you have adjusted your habits and have maintained this good lifestyle for some time (about 4 weeks), but the symptoms of constipation still do not resolve; then it is time to consider medication. What are the medications used to treat constipation? There are two main types of medications for constipation: 1) stimulant laxatives; 2) laxatives. Among them, stimulant laxatives mainly stimulate the sensory nerve endings in the colonic mucosa to speed up the movement of the colon, or promote the secretion of colonic fluid from the intestinal mucosa to help defecation. The effect of stimulant laxatives is strong and diarrhea usually occurs after using them. Therefore, patients may feel that their bowel is clear and mistakenly believe that their constipation symptoms are relieved. Stimulant laxatives mainly include stimulant plant-based laxatives, lubricant-based laxatives and salt-based laxatives. 1, stimulating plant laxatives: mainly refers to plants containing anthraquinones (such as senna, rhubarb, aloe, cassia, etc.), phenolphthalein (fruit guide, etc.) and castor oil, etc. The “diet tea” category, “detoxification” category, “cleanse” category of health products on the market belong to this type of laxative. So, these drugs are really as advertised as “safe, non-stimulating, no side effects”? In fact, if you eat these drugs for a long time, our intestinal mucosa will slowly change from red to dark brown, or even black, this situation is colon melanosis. Some people take them for only a few weeks, and they can cause colon blackening. And colon melanosis may be related to colon cancer. The National Institutes of Health (NIH) found in animal carcinogenicity tests that anthraquinones are carcinogenic to mice and rats. Doctors do not advocate that patients take this so-called “detoxification class” of irritating laxatives for a long time. Castor oil itself is toxic, and is not suitable for long-term use. Therefore, this type of laxative must be carefully chosen! 2, lubricating laxatives: mainly some inorganic mineral oil, such as glycerin, liquid paraffin, etc.. These mineral oils, which are not absorbed by the colon, can lubricate the intestinal wall; they can also hinder the absorption of water in the intestines, increase the water content of stool, soften the stool, thus promoting defecation. The commonly used corkage is this kind of laxative. Many people will think that lubricating laxatives is to play the role of lubrication, but in fact, the more important role of these laxatives is to stimulate rectal dilation, inducing the production of defecation reflex. Many patients respond that these agents are not effective, but after asking the doctors, they realize that these patients squeeze the lubricating laxative in and then excrete it immediately, which is not possible. It is necessary to let the laxative stay in the rectum for a longer period of time (a few minutes to ten minutes) to stimulate the rectum to dilate and induce propulsive peristalsis of the colon after the emergence of bowel movement, so that the stool can be passed smoothly. It is generally accepted in the medical community that this defecation reflex is not a normal physiological stimulus. Under normal circumstances, the contents of the rectum (stool) do not produce such a strong pressure stimulus to the rectum. Squeezing in a lubricant laxative causes the rectal wall to expand and increase, creating a strong pressure stimulus to the rectum and thus inducing a defecation reflex. With long-term use of such laxatives, the sensitivity of the rectum to pressure stimulation becomes less and less, and the defecation reflex can be induced only under very strong stimulation (with lubricating laxatives), and without medication, no bowel movement is produced and normal defecation is not possible. This situation is extremely unfavorable for the patient, so the doctor will use this type of laxative with caution. Only if the patient has severe constipation symptoms, such as prolonged inability to defecate and very dry, hard stools, will the patient be advised to use lubricating laxatives intermittently for a short period of time. These drugs can only play a temporary relief role, not as a means of long-term treatment, not long-term use! 3, salt laxatives: mainly refers to a class of laxatives containing magnesium salts, sodium salts, etc.. Salt laxatives have an osmotic effect, the soluble components of which can be absorbed by the intestine, which in turn produces a strong stimulation of the mucosa of the large intestine, inducing colonic movements and promoting defecation. Patients who take these laxatives will have obvious diarrhea, and severe diarrhea will lead to loss of nutrients (including electrolytes) in the body, resulting in disorders of electrolyte metabolism in the body. Furthermore, with the long-term use of salt laxatives, the sensitivity of the intestine to stimulation will become less and less, and the colon will move only under strong stimulation, which will lead to poorer and poorer colon dynamics. Therefore, salt laxatives are not used in general, but only for a short time in special cases, such as intestinal obstruction, intestinal fecal impaction (due to dry and hard feces that cannot be expelled by themselves), etc. In short, stimulant laxatives are not recommended by doctors for long-term use. On the one hand, the stimulation of the intestinal tract by these laxatives often affects the synthesis of neurotransmitters in nerve cells, whose main role is to be responsible for signal transmission. With long-term use of such laxatives, the synthesis of neurotransmitters in the patient’s body becomes less and less, and the intestine becomes less and less sensitive to stimulation, requiring very strong stimulation to respond. Without the use of such laxatives, patients will not be able to have normal bowel movements. On the other hand, with long-term use of stimulant laxatives, the patient’s colon wall will become more and more flabby, the muscle tone will become less and less, and eventually the colon movement will become very weak or even stagnant, so that it will not be able to transport food residues at all, and it will be almost impossible to defecate, and it will be difficult to restore the normal rhythm of defecation in this case.